Ali Omar, Banerjee Swati, Kelly Daniel F, Lee Phillip D K
Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Pituitary. 2007;10(4):359-64. doi: 10.1007/s11102-007-0060-8.
Pituitary gigantism, a condition of endogenous growth hormone (GH) hypersecretion prior to epiphyseal closure, is a rare condition. In the adult condition of GH excess, acromegaly, the occurrence of type 2 diabetes mellitus (T2DM) and diabetic ketoacidosis (DKA) have been reported, with resolution following normalization of GH levels. We report the case of a 16-year-old male with pituitary gigantism due to a large invasive suprasellar adenoma who presented with T2DM and DKA. Despite surgical de-bulking, radiotherapy and medical treatment with cabergoline and pegvisomant, GH and insulin-like growth factor-I (IGF-I) levels remained elevated. However, the T2DM and recurrent DKA were successfully managed with metformin and low-dose glargine insulin, respectively. We review the pathophysiology of T2DM and DKA in growth hormone excess and available treatment options.
垂体巨人症是一种在骨骺闭合前内源性生长激素（GH）分泌过多的疾病，较为罕见。在成人GH分泌过多的疾病肢端肥大症中，已有2型糖尿病（T2DM）和糖尿病酮症酸中毒（DKA）的发生报道，且GH水平恢复正常后病情缓解。我们报告了一例16岁男性因巨大侵袭性鞍上腺瘤导致垂体巨人症，该患者出现了T2DM和DKA。尽管进行了手术减瘤、放疗以及使用卡麦角林和培维索孟进行药物治疗，但GH和胰岛素样生长因子-I（IGF-I）水平仍居高不下。然而，分别使用二甲双胍和小剂量甘精胰岛素成功控制了T2DM和复发性DKA。我们回顾了生长激素过多情况下T2DM和DKA的病理生理学以及可用的治疗选择。
